title: The innate immune system and transplantation.
abstract: The sensitive and broadly reactive character of the innate immune system makes it liable to activation by stress factors other than infection. Thermal and metabolic stresses experienced during the transplantation procedure are sufficient to trigger the innate immune response and also augment adaptive immunity in the presence of foreign antigen on the donor organ. The resulting inflammatory and immune reactions combine to form a potent effector response that can lead to graft rejection. Here we examine the evidence that the complement and toll-like receptor systems are central to these pathways of injury and present a formidable barrier to transplantation. We review extensive information about the effector mechanisms that are mediated by these pathways, and bring together what is known about the damage-associated molecular patterns that initiate this sequence of events. Finally, we refer to two ongoing therapeutic trials that are evaluating the validity of these concepts in man.
authors.affiliation: MRC Centre for Transplantation, Division of Transplantation Immunology and Mucosal Biology, King's College London School of Medicine at Guy's, King's College and St. Thomas' Hospitals, London SE1 9RT, United Kingdom.
authors.forename: Conrad A
authors.initials: CA
authors.lastname: Farrar
authors.forename: Jerzy W
authors.initials: JW
authors.lastname: Kupiec-Weglinski
authors.forename: Steven H
authors.initials: SH
authors.lastname: Sacks
mesh_terms: D064591:Allografts / Q000276:immunology; D000818:Animals; D002986:Clinical Trials as Topic; D003165:Complement System Proteins / Q000276:immunology / Q000502:physiology; D006084:Graft Rejection / Q000276:immunology; D006801:Humans; D007113:Immunity, Innate / Q000276:immunology*; D051379:Mice; D015427:Reperfusion Injury / Q000276:immunology; D013601:T-Lymphocytes / Q000276:immunology; D051193:Toll-Like Receptors / Q000276:immunology / Q000502:physiology; D014181:Transplantation Immunology / Q000276:immunology*
chemical_list: D051193:Toll-Like Receptors; D003165:Complement System Proteins